Paget disease of the breast

Case contributed by Dr Maulik S Patel

Presentation

Right breast exophytic lump replacing the nipple for the last few weeks.

Patient Data

Age: 60 years
Gender: Female
Ultrasound

There is an exophytic, well-defined, heterogeneously hyperechoic lesion replacing the right nipple measuring about 38 x 35 x 32 mm. The lesion extends into deeper breast parenchyma without involving the muscle. The lesion shows significant vascularity. The rest of the breast shows fatty parenchyma. There are two, enlarged, non-necrotic nodes in the axilla; lateral to the pectoralis minor. The largest node measure 17 mm on the short axis. There is a loss of hilar fat in the nodes. There is a round-shaped hypoechoic nodule ( 6 x 5 mm ) between pectoralis minor and major in the infraclavicular region. It is located near the edge of the pectoralis minor muscle. There is no internal mammary adenopathy.

Case Discussion

An elderly female presented with a mass replacing the nipple. Ultrasound shows features of a malignant mass lesion with axillary lymphadenopathy.

Biopsy revealed features of invasive papillary carcinoma as well as invasive ductal carcinoma.

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